Provigil for Multiple Sclerosis

A study
in Europe concluded that Provigil could improve sleep quality and
daytime fatigue in mulitple sclerosis patients, and that a lower dose
was needed than for people with narcolepsy. Another
study seemed to contradict that finding, and showed no benefit to
MS patients.

Experts debate the definition and pathophysiology of fatigue in multiple
sclerosis and there is no real way to quantify fatigue, which is subjective.
But everyone agrees it is an important topic for MS patients. Fatigue
is the most frequently reported symptom of multiple sclerosis; it limits
activity and participation in many areas of life and causes psychological
distress.

Fatigue management is based on a comprehensive evaluation of its characteristics
and consequences (sometimes with the use of scales such as the Fatigue
Severity Scale and the Modified Fatigue Impact Scale), and on the identification
of many potential contributing factors (psychological disorders, sleep
disturbances, pain, infections and other comorbidities, medications, and
deconditioning). Rehabilitative interventions are essential to the treatment
of fatigue. Beyond the traditional energy conservation strategies and
cooling techniques, several randomized controlled studies have demonstrated
the positive impact of aerobic exercise.

Further, multiple sclerosis patients often experience cognitive impairment,
which may share a common physiopathological substrate with fatigue. Not
much is known about effective strategies for managing cognitive impairment
in multiple sclerosis. Small trials with amantadine, pemoline, 4-aminopyridine
and 3–4 aminopyridine have provided mainly negative results.